Provider Demographics
NPI:1992886055
Name:SALVATORE, SUSAN V (MA, LPC, NCC)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:V
Last Name:SALVATORE
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 HILLSIDE RD
Mailing Address - Street 2:
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840-4140
Mailing Address - Country:US
Mailing Address - Phone:908-684-9495
Mailing Address - Fax:973-625-7110
Practice Address - Street 1:50 MORRIS AVE
Practice Address - Street 2:REHABILITAION SERVICES
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834-1735
Practice Address - Country:US
Practice Address - Phone:973-625-7057
Practice Address - Fax:973-625-7110
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00003500101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4138601Medicaid
NJ4138601Medicaid